| NPI | 1275973414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-16-23275) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 0-15-6933) |
| 247200000X Technician, Other | |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2022-07-15 |